Most common method is to remove the colon by keyhole surgery, followed by keyhole pouch surgery, but requiring a small cut to be made.

Pouch function can deteriorate over time and patients can be offered repeat pouch surgery, but the outcome is not as good as the initial pouch surgery.

Kock Pouches (an alternative to an end ileostomy) are now being formed by creating a reservoir behind the stoma whereby the patient does not wear a bag but catheterizes the stoma every 3 or 4 hours and a small stoma cap may be used to contain mucous leakage. Patients can be offered this surgery following a failed pouch. This is a major, technical operation requiring repeat surgery and has a 60% success rate.

Making the decision – many people wanted control of what was happening

“ I got to the point when I said look I’ve had enough I want to have the operation……I said look you have got to get someone to do something about this, I was up 22-24 times an hour. I was soiling the bed. I had no control”

High motivation, but no guarantees

Dietary modifications

Diet

50% individuals modify their diet

Not adequately discussed by Health Care Professionals

Attitudes towards food; eating what you want or to reduce pouch issues

“I eat late and do not follow any rules, I don’t do any of those things your supposed to do. I do what everyone else is doing. I have a drink, life’s too short!!”

At the JR one third of pouch patients do not have enough haemoglobin in their blood and 22% lack iron.

Iron deficiency is caused by blood loss from the gut.

Iron deficiency is usually treated with tablets (which may have side effects and is slow to act). Iron injections are also available which can be given in a larger does and is rapidly absorbed with few side effects and is not likely to cause inflammation.

The JR are now offering iron injections to patients and are routinely looking for patients lacking in iron who may be asked to participate in the study.

All patients who come to pouch clinic or have telephone pouch follow ups are asked to get their bloods taken and a low iron count will be picked up and you will be asked to take part in the study. The study will commence shortly for 6 months.

12.30 Lunch

An opportunity to meet and chat with other pouch owners and their partners and talk to representatives from a number of pharmaceutical companies and the NACC & IA

The digestive system is a muscle system working its way through the body.

To teach exercises members were asked to think of the middle of the body as a box. The pelvic floor muscles are made up of 2 layers and are the bottom of the box. The deep core abdominal muscles at the front and back of the body are the sides and the diaphragm is at the top.

To strengthen the core abdominal muscles lift the legs either side standing up or on all fours keeping the trunk still. (A superman action on all fours) This will help build up tone.

Support for the Pouch comes from the tone of your muscles. These should be strengthened little and often and do not need to be strenuous.